BPD mu preterm vacheche - chii?

Bronchopulmonary dysplasia (BPD) mu vakurumidze vacheche kusimukira pamusoro mazhinji kuona mukuru okisijeni nevezera akasikwa kubudikidza unomubatsira kufema. Kubvisa chirwere, mwana kunoda vavashandire zvainanga pakuponesa upenyu hwake. Ngationei kuti chii, zvinokonzera, zviratidzo uye pakurapa pathological zviri chinonakidza.

BPD mu preterm vacheche - chii?

Kids vakaberekerwa nguva isati yakwana ari mashoma, kupesvedzera zvirwere zvakasiyana-siyana nemhaka yokushayiwa kukura zvomukati. Chinenge mwana wose ane vakadaro zvarakasiya zvakakomba mune kufema ino. Kuti tirambe runodiwa nenhanho okisijeni mwana kunofambidzana munhu ventilator. zvokushandisa ichi, izvo anodzora mwando, tembiricha uye kubuda mwero gasi muvhenganiswa wakawanziridzwa nekaviri kufema. A kakawanda kuomesa nzira iyi ndiyo bronchopulmonary dysplasia.

Bronchopulmonary dysplasia mu preterm vacheche anovandudza kana chavakaona yakakwirira kuwanda okisijeni kwenguva yakareba. Kana mwana ari ventilator mazuva anopfuura 28, pangozi chirwere inowedzera yekudyidzana. Rare chirwere kunoitika muna vana vakaberekerwa izwi, pashure kurwara Árbol sepombi uye nemapapu.

Pari, zvose nyaya itsva mhando BPD kazhinji wakaiswa, umo mapapu vane risingamboshandisi alveolarization mwana, zvishoma akacherekedza kuoma kufema uye pulmonary nemidziyo. Zvichienzaniswa kune "chaiwo" bronchopulmonary dysplasia, a "chiedza" chimiro maperembudzi Kutamiswa nyore zvikuru.

Zvinokonzera BPD

Kuitika bronchopulmonary dysplasia akanyorwa pashure nokuchinja kubvisa mwana kubva ventilator. Nyanzvi dzinoti pane pathological chakajairika nokuda migumisiro yakaisvonaka okisijeni iri underdeveloped pulmonary marongerwo. Just dzinokosha zvinokonzera BPD pangozi zvinosanganisira zvinotevera:

• kupinda bronchopulmonary hurongwa zvinokonzera zvirwere;
• Kutarisirwa zvisina kufanira surfactant;
• pulmonary neBP kunokonzerwa malformations mwoyo;
• kukuvara zvemapapu rinenge kana zvakabatana kuti ventilator;
• pulmonary edema;
• vhitamini kwokusakwana.

Zvikurukuru yakajairika BPD mu preterm chaizvo vacheche. chikamu ichi zvinosanganisira vakaberekwa pamberi vhiki 29 uye haaremi pane 1500 surfactant mamiriro vasina kwakakwana. Izvi zvinotungamirira chokuti munguva expiratory zvemapapu Formação de dzinotanga kunamatira pamwe uye kuva hunenge, izvo chinokurwadzai kuderera negasi exchange. Kudzivisa varwadziwe, mwana zvakabatana kuti ventilator.

Zviratidzo BPD

Kuratidzwa rokutanga chirwere yakanyorwa mushure nokuzviparadzanisa mwana kubva ventilator. Pakarepo zvingaita kuti mwana wako ane mafungiro kuitika, asi pashure penguva yakati pane ngozi anonongedzera. Kupfuura zvose, vabereki vanofanira kuteerera kupfupika mweya. Kana mbudzana kunoita kundosvikira anopfuura 60 paminiti, mhino flaring zvakasimba uye chipfuva ane dhiramu chitarisiko, nekukurumidza kuti kurapwa.

Noruzha kufema, phlegm mumapapu, akawedzera mweya, rinokwanisa kucheneruka ganda - kakawanda zviratidzo BPD mune rokusamhanyira vacheche. Chii chinonzi chirwere ichi uye sei kuti zviite mwana ezvinhu? Zvipatara akasarudzwa chiremba zvichienderana kwokuomerwa mwana chete. Pre-wakaitwa chirwere matanho: kuongorora zvokunze, Ultrasound kwemoyo, chipfuva X-ray. Uyezve, rabhoritari nemiedzo, kubvunza pulmonologist unogona kupiwa.

BPD kurapwa

Vakurumidze vacheche zvokurwara kubatwa symptomatically. Chinangwa chikuru chemusha kurapa kwakadaro kunoratidzwa chokubvisa zviratidzo zvacho chirwere uye normalization kufema. Duration kurapwa - kubva mavhiki kusvika 2-3 mwedzi.

Kusiyanisa pakati munyoro, mwero uye yakanyanya bronchopulmonary dysplasia. Munguva pavaipfuura chirwere akacherekedza exacerbation nekangamwiro. Drug kurapa kunosanganisira kushandisa corticosteroids, diuretics, mishonga (kana zvakakodzera), bronchodilators, surfactants.

zvinodhaka Antibacterial inodiwa tunodzivisa kukura chokutsva. Vaiona Zvakanyanya Kunaka Panguva Yepamuviri mushonga kubva macrolide kuti zvinobudirira kukwikwidzana ine chakarondedzera utachiona.

kurapa Features

Pasinei chokuti chirwere chinokurwadzai zvokuimba kufefetedza ari kurapwa kwacho uye zvinoda okisijeni mishonga. Unobva mwana kuti muchina zvinokosha inonzi kufema maitiro, uye zvose munyama hwakakwana okisijeni. Saka wevasungwa pamusoro gasi akavhenganiswa uye kumanikidzwa iri midziyo ipfupi napo. Zvichakubatsirawo zvinoda kuramba zvichiongororwa pakati okisijeni muropa vomwana.

Kana BPD mu preterm vacheche vanofanira kudya zvokudya. Zvakakosha kuti muviri wemwana zvizhinji yakakwana mapuroteni uye nokudaro kudzivirira zvakawandisa zvokunwa. Kana mamiriro mwana inorema inotonhorera muvhenganiswa chinotarisirwa ne gavage. The mvura Vhoriyamu kunoderedza kuti 110 Rine mamiririta muzana makirogiramu kurema muviri pazuva kudzivirira kukura pulmonary edema.

Kushandiswa mahormone

Kemikari kurapa zvinokosha kubvisa chokutsva ari kufema turakiti, kunoitika pazuva pakanyorwa bronchopulmonary dysplasia. Systemic glucocorticoids raitongwa kubva pamazuva okutanga oupenyu kana mwana ari vakanonga uri ventilator. Izvi kunoderedza ngozi chakakomba abnormalities ari kufema hurongwa.

Cherechedza kuti kemikari mishonga ine payakaipira wandei, huru zvacho parutivi migumisiro hyperglycemia, BP, hypertrophic cardiomyopathy.

Aanoda rinowanzoshandiswa kupiwa inhaled steroids. Ivo vanoda chipimo chemushonga duku zvikuru uye kukanganisa chete dzapasi kufema turakiti. Panguva iyoyowo, kurapa ino inopa chete kwekanguva kunobatsirawo mu Muzviitiko zvakaipisisa.

"Dexamethasone" - mumwe inonyatsobudirira uye nokukurumidza kuita zvinodhaka kubva boka glucocorticoids. Zvinonzi nezvaro vanenge ruyamuro kubva chakasimba kuratidzirwa chirwere. Uyewo, kuti zvinodhaka kunodzivisa nokuumbwa kurwiswa itsva.

Mabatirwo BPD vakurumidze "Dexamethasone" vana vanogona kudzvinyirira nezvaizoitwa interleukin - pakugadzira vanoshingaira zvinhu kupinda kunzvimbo principales uye rinobatanidzwa anogumbura kwendangariro. The mushonga kunodzivisa pave kufema kukundikana uye zvachose njodzi kuti mwana.

"Dexamethasone": rondedzero zvinodhaka

The medicament chinhu simba chakaita zvokugadzirwa glucocorticoid mumiririri dzakatevedzana. Kuitwa "Dexamethasone" nechinangwa panguva normalization yacho puroteni, chicherwa uye carbohydrate muviri mumuviri. It ane simba Anti-anogumbura, antiallergic, uye protivosokovmi antitoxic zvivako. Kushoma hakuperi nokuda yekudyidzana kuderedza kwetunhu rechikepe masero uye eosinophils, izvo zvibereko proinflammatory nevamiririri.

Nokuti pakurapa bronchopulmonary dysplasia mu vacheche vaishandisa mhinduro mune ampoules. The chipimo chemushonga anosarudzwa nomunhu chete. Yeuka kuti kushandisa zvinodhaka pfupi-rine immunosuppressive zvinokonzerwa, uye kurapa kwenguva refu kunowedzera ngozi pakubatana chirwere yechipiri.

Diuretics mu BPD

Pasinei rutapudzo rugwaro mvura kudyiwa mu vakurumidze vacheche pamwe BPD, kudzivisa panowanikwa edema yakatarwa diuretics - diuretics. Dzavo kuchirapa zvazviri inoendeswa normalization ari asidhi-nechigadziko mwero uye vasanyanye uwandu Urume munyama.

"Furosemide" anowanzodanwa kushandiswa pakati maitiro diuretics. The dambudziko rokugadzirira ichi ndiko mhanyisa mvura reabsorption mumapapu uye kuvandudza pulmonary Vanamakanika edema.

Maberere nemigumisiro

Bronchopulmonary dysplasia chakakomba zvikuru uye chirwere ngozi. In chirwere chakakomba rakaipa muna 20% nyaya. In nyoro kuti zvive nomwero chirwere uye kuvandudzika mwana zvinobvira vabudirire mukati mwedzi upenyu chokutanga. kazhinji sei zvakaipa pashure BPD mu preterm vacheche? Nyanzvi Guest vanoti kuti vana ava vanotambura yezvirwere zvirwere zvokufema, BP, kupererwa neropa, kunonoka kwomuviri.